Thursday, 13 October 2011

HEMIPLEGIA + O.A BOTH KNEE

This is the case of mrs indira devi, 50yrs, female ,vinayak nagar,ganteyada gajuwaka, vishakapattanam. she came to me with the complaints of paralysis of right side of the body since six weeks with urinary incontinence and third stage osteo arthritis both knee ,and severe edema of rt ankle .

while getting into her history she had a brain injury six weeks back during a train journey and her MRI brain shows ACUTE INFARCTION INVOLVING THE BRAIN STEM. she got admitted in a famous hospital in vishakapattanam and they gave the emergency management with the advice of physiotherapy, but there was not any marked relief during this period and the patient got admitted at our hospital.

This was again a challenging case, we are confident with our medicines and treatment ,the main concern was osteoarthritis knee, even if her nervous system and musculoskeletal system regains its normal function the degenerated knee joint can damage the results due to lack of stability, but we had many O.A cases which got very good results after treatment. we plan 30 days treatment .

In our experience most of the cases with infarcts respond within one week of treatment, and the patient slowly get strength in there lower limbs which enable them to drag there limbs , upper limbs respond late in almost all the cases mainly wrist and finger movements . in her case it was on the 5th day she started slowly raising her leg only for a moment, it gradually got improved. we gradually removed her catheter, body responded and she was able to hold urine for some moment. Her condition got improved day by day and she was able to stand with support after 3 weeks , but her knees started making problems since they lack stability and loss of cartilage made the condition worse, but her motor activity got better and muscles started functioning back to normal.

gradually on the 4th week of her treatment she started walking with support and was trying to move her limbs with some effort, slowly the condition improved and she used to walk with support 100 mtrs per day and it got improved to around 500mtrs/day during the time of discharge, .

At the time of discharge she was able to stand without support walk with some support and her urinary incontinence reduced. she got discharged and is under our observation at the moment.